MENSTRUAL FUNCTION AND PHYSICAL AND MENTAL JOB STRESS

月经周期是女性生育潜力的标志， 监测从未尝试或实现怀孕的女工，但 他们的生殖功能和与生殖相关的慢性疾病的风险可能 但也会受到工作环境的影响。 本申请要求 调查女工月经功能和研究 身心工作压力的影响，以及与压力相关的行为 比如咖啡因摄入量，对周期特征和卵巢激素的影响 模式. 压力是一种普遍的职业暴露， 可以预防或减少。 它被牵连到 月经失调，也被认为是一种可能的替代方法， 对接触其他有害物质的工人中不良妊娠结果的解释 代理（例如VDTs）。 工作压力可能是女性的一个特殊问题， 其所谓的“第二次轮班”的额外责任并不 在非工作时间内容易从压力中恢复过来。 项目 因此，我们建议解决两个重要问题：（1）工作压力， 女性-暴露的影响需要严格的调查， 自己的优点，并帮助解开压力的影响，从其他影响 工作场所的代理人;和（2）需要开发的生物标志物， 月经功能，以确定和预防与工作有关的疾病 在非怀孕妇女中（就像精液分析用于监测男性一样）， 职业暴露）。 我们建议招收100名女护士，从高年级和低年级各抽取50名 纪念斯隆-凯特琳癌症中心（MSKCC）的压力区域， 连续的月经周期。 将要求受试者记录基础体重 温度，每天收集一小部分尿液，并保持 月经日记 评估排卵和黄体功能， 将分析尿样中的雌酮-3-葡糖苷酸（E1 G）， 孕甾烷-3-葡糖苷酸（pdG）、促黄体生成素（LH）和肌酐 （Cr）。 由于护士的工作量大，因此被选为目标人群 压力水平，因为高咖啡因摄入量和愿意遵守 一项可行性研究表明， 在MSKCC支持这一点。 受试者将由护士现场招募 MSKCC现场主管，他将确定 档案材料的基础和与管理人员的讨论。 数据分析将评估与工作相关的强度的关系 压力源、咖啡因摄入和接触抗真菌塑料，以及 月经功能的几个指标（周期长度;排卵;和黄体功能） 相位适当性）。 E1 G和PdG的绝对水平和变化率将 也可以与曝光进行比较。 最后，为了帮助设计 未来的月经研究，基础体温的有效性， 将评估月经周期的前瞻性确定报告， 以尿激素数据为金标准

The menstrual cycle is a marker of female fertility potential and can serve to monitor female workers who never attempt or achieve a pregnancy, but whose reproductive function and risk of hormone-related chronic disease may nonetheless be affected by the work environment. this application requests monies to investigate menstrual function in women workers and to study effects of physical and mental job stress, and stress-related behaviors like caffeine consumption, on cycle characteristics and ovarian hormone patterns. Stress i s pervasive occupational exposure and one that potentially can be prevented or reduced. It has been implicated in menstrual disorders and has also been cited as a possible alternative explanation for adverse pregnancy outcomes among workers exposed to other agents (e.g. VDTs). Job stress may be a particular problem for women, whose added responsibility for the so-called "second shift" does not readily allow for recovery from stress during nonwork hours. the project we are proposing thus addresses two important issues: (1) job stress in females - an exposure whose effect needs rigorous investigation both on its own merits and to help disentangle stress effects from effects of other work place agents; and (2) the need to develop biological markers of menstrual function in order to identify and prevent work-related disorders among non-pregnant women (much as semen analysis has served to monitor male occupational exposures). We propose to enroll 100 female nurses, 50 each drawn from high and low stress areas of Memorial Sloan-Kettering Cancer Center (MSKCC), for three consecutive menstrual cycles. Subjects will be asked to record basal body temperature, collect a small aliquot of urine daily and maintain a structured menstrual diary. To evaluate ovulatory and luteal function, urine samples will be analyzed for estrone-3-glucuronide (E1G), pregnanediol-3-glucuronide (pdG), luteinizing hormone (LH) and creatinine (Cr). Nurses were selected as the target population because of high job stress levels, and because high caffeine intake and willingness to comply with a demanding regimen also seemed likely; a feasibility study conducted at MSKCC supports this. Subjects will be recruited by a nurse-field director on-site at MSKCC who will identify high and low stress units on the basis of archival material and discussions with administrators. Data analyses will evaluate the relations in the intensity of job-related stressors, caffeine consumption, and exposure to antineoplastics, and several measures of menstrual function (cycle length; ovulation; and luteal phase adequacy). Absolute levels and rates of change in E1G and PdG will also be compared in relation to exposure. Finally, to aid in the design of future menstrual studies, the validity of basal body temperature and prospectively ascertained reports of menstrual cycles will be assessed, using the urinary hormone data as a gold standard.